Fertility treatments and cancer

Fertility treatment after cancer

After cancer treatment, you may decide you want information about starting a pregnancy with fertility treatment. This may not be a straightforward decision for everyone. Sometimes moral, cultural or religious views about fertility treatment can make the decision complicated.

Your cancer doctor or GP can refer you to a fertility clinic for advice and support.

Starting a pregnancy with fertility treatment can be an option for:

single people
straight couples
same-sex couples
people of all gender identities.

Whatever your situation, it is important to get the right information. This will help you make decisions that are right for you.

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Fertility and cancer

At the fertility clinic

At the clinic, the specialist will talk to you about your fertility and treatments that may help. If you are planning to start a pregnancy with a partner, they should also be involved.

The fertility specialist will answer your questions and arrange any tests you need . They will also ask you questions about your lifestyle. There might be lifestyle changes you can make to help improve your fertility, such as stopping smoking.

Unfortunately, fertility treatment does not always result in a pregnancy. The doctor will give you information about the success rates of different types of fertility treatment in your situation.

This can be a lot of information to take in. A specialist fertility counsellor at the clinic can support you and any partner as you think about the information. They can help you make decisions about what you want to do.

Many children have been born using fertility treatments. There do not seem to be any long-term health risks for the child. Your fertility doctor can give you more information about any possible risks of these treatments.

Where to get fertility treatment

This depends on whether you have NHS treatment or private treatment.

All UK fertility clinics are licensed by the Human Fertilisation & Embryology Authority (HFEA). You can find advice about choosing a clinic and details of clinics on the HFEA website.

Your GP can tell you which clinics offer NHS treatment in your area. If you have already had fertility preservation or fertility tests, you may be able to go back to the same clinic.

For private treatment, you can choose a clinic. You can arrange this yourself, but it can be useful to have a referral letter from your GP.

Cost of fertility treatment

The NHS may pay for a certain number of fertility treatments. The funding rules about this are different in different areas of the UK.

If you decide to have fertility treatment, it is important to remember that the funding rules apply to both you and any partner you have fertility treatment with. Your GP, cancer doctor or fertility doctor can give you information about this.

Private fertility treatment

Some people choose to pay for some, or all, of their fertility treatment privately. You may be thinking about this if:

you are not eligible for NHS treatment
you are worried about NHS waiting times
the NHS does not provide the treatment you want or need.

Fertility treatment is expensive and there are no standard charges for private treatment. You can contact clinics directly to find out which treatments they offer, how much they charge and their success rates.

Types of fertility treatment

Types of fertility treatment include:

Intra-uterine insemination (IUI)

For IUI, the fertility doctor or nurse puts collected sperm directly into the womb. They use a fine tube called a catheter. They pass this through the cervix and into the womb. If an egg is fertilised, a pregnancy may develop.

IUI is usually timed for the day after the ovary is most likely to release an egg. The IUI procedure only takes a few minutes. It usually feels similar to having a cervical smear test.

Good-quality sperm is needed for IUI. It may not be an option using sperm that was collected and frozen.
In vitro fertilisation (IVF)

IVF treatment happens in a laboratory. Collected eggs and sperm are mixed together in a dish. If suitable embryos develop over the next few days, 1 or sometimes 2 can be transferred to the womb to see whether a pregnancy develops. This is called an embryo transfer.

The fertility doctor or nurse passes a catheter through the cervix and into the womb to do this. Good-quality embryos can also be frozen for future use.
Intra-cytoplasmic sperm injection (ICSI)

the doctor uses a microscope during the extraction. This helps them select fluid and tissue from the testicle or the epididymis that is most likely to contain sperm.

If suitable embryos develop, 1 or sometimes 2 can be transferred to the womb through embryo transfer to see whether a pregnancy develops. Good-quality embryos can also be frozen for future use.
Embryo transfer

If suitable embryos develop with IVF or ICSI, the fertility doctor or nurse places 1 or sometimes 2 embryos into the womb to see whether a pregnancy develops. They use a catheter. They pass this through the cervix and into the womb. Any other good-quality embryos can be frozen for future use.

Using fresh or stored sperm, eggs or embryos

Fertility treatments can use fresh or stored sperm, eggs or embryos. Stored samples will be carefully thawed (unfrozen) in a laboratory when needed.

Sperm samples that have been collected using surgery are used with ICSI. Sperm samples that have been frozen may be suitable for IUI, IVF or ICSI, but this can depend on the quality of the sample.

Using a donor

Some people use donated sperm, eggs or embryos with fertility treatment. This might be an option if:

you or your partner’s fertility is affected and you do not have stored sperm, eggs or embryos to use
you are in a same-sex relationship
you are single.

People usually have questions about using a donor. The fertility clinic will offer you counselling to help you think about the possible issues.

You may have to wait to find a suitable donor in the UK. Using a donor may not be funded by the NHS in some areas. Some people decide to pay for a donor in the UK or from another country. Your fertility clinic can explain what is available.

Donors

Everyone who donates sperm, eggs or embryos in the UK sees a doctor at the fertility clinic before they donate. The doctor examines them and asks them questions about their medical history. They also test them for infections, such as HIV, hepatitis B, hepatitis C and some genetic conditions.

You can be matched to a donor. For example, you can be matched by:

ethnic origin
eye colour
hair colour
physical build.

All UK donors must agree to their details being available in the future. Any child born from fertility treatment using a donor can ask for the donor’s details when they are 18 years old.

Some people ask a family member to be their donor. They will have the same tests as any other donor.

Using a surrogate

Surrogacy means that another person gives birth to a baby for you. They are called a surrogate or host. The pregnancy may be started using IUI or IVF. This might be an option if you:

are not able to carry a pregnancy
have a partner who is not able to carry a pregnancy.

Surrogacy pregnancies can be started using the surrogate’s own eggs. It is also possible to use your own eggs or embryos, or donor eggs or embryos.

Surrogacy is not common in the UK. It can be expensive, and the laws in the UK are complicated. Organisations such as Childlessness Overcome Through Surrogacy (COTS), Surrogacy UK and Brilliant Beginnings can give you more information and support.

If fertility treatment does not work

Unfortunately, there is always a risk that fertility treatment will not be successful. This is a risk for anyone having fertility treatment, not just people affected by cancer.

Your fertility doctor will explain your chances of success before you start any fertility treatment. But it is still upsetting if treatment does not work.

Some people decide not to try again. Or they may think about other options such as adoption or fostering. Others decide they want to continue with fertility treatment.

These can be hard decisions to make. Fertility treatment can be stressful. It can be hard physically as well as emotionally. If you are paying for treatment, it is also expensive.

A counsellor in your fertility clinic can offer support and advice. There are also organisations that offer counselling, such as the British Infertility Counselling Association (BICA). Your healthcare team might know about support groups in your area. Or you can join our Online Community to talk to other people who are going through the same thing.

About our information

References

Below is a sample of the sources used in our fertility and cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

Lambertini M, Peccatori FA, Demeestere I, et al. Fertility preservation and post-treatment pregnancies in post-pubertal cancer patients: ESMO Clinical Practice Guidelines. Annals of Oncology, 2020; 31, 12, 1664-1678.

National Institute for Health and Care Excellence. Fertility problems: assessment and treatment. [Internet]. 2017, Available from www.nice.org.uk/guidance/CG156 [accessed November 2022].

Reviewers

This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Chief Medical Editor, Professor Tim Iveson, Consultant Medical Oncologist.

Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

The language we use

We want everyone affected by cancer to feel our information is written for them.

We want our information to be as clear as possible. To do this, we try to:

use plain English
explain medical words
use short sentences
use illustrations to explain text
structure the information clearly
make sure important points are clear.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.

You can read more about how we produce our information here.